This proposal describes a five-year training program for career development in academic cardiovascular medicine for Dr. Benjamin Olenchock. Dr. Olenchock is an M.D.-Ph.D. physician scientist and prior trainee of the NIH-sponsored Medical Scientist Training Program. He has completed clinical training in Cardiovascular Medicine and Critical Care Medicine through American Board of Internal Medicine accelerated research pathway. He is now embarking on a research and career development program under the mentorship of William G. Kaelin, M.D., Professor of Medicine at Harvard Medical School and the Dana Farber Cancer Institute, and member of both the Institute of Medicine and the National Academy of Sciences. Dr. Kaelin is a world-renown researcher in hypoxia and cellular metabolism, and has a long track record of mentoring trainees who go on to successful, independent research careers. Dr. Olenchock's career development plan includes educational resources at Harvard Medical School, the Dana Farber Cancer Institute, and the Massachusetts Institute of Technology. Additional career development support is provided by the Brigham and Women's Hospital Division of Cardiovascular Medicine, where the principle investigator will serve as attending physician in the Cardiac Intensive Care Unit (CICU) during the period of funding. He has developed a clear timeline for publication of his work in peer-reviewed journals, presentations at national meetings, and plans for the development of independent research projects and funding. Dr. Olenchock is interested in developing novel treatment strategies for conditions he treats in the CICU such as myocardial infarction, systolic heart failure, hypoxic respiratory failure, or cardiac arrest. These conditions have a common pathophysiology of impaired oxygen delivery to tissues. He is investigating the mechanisms by which this common pathophysiology-limited oxygen availability- alters cellular metabolism, and specifically the role played by a family of oxygen-sensing enzymes called EglNs. He has found that inhibition of EglN1 protects against cell death after cardiac ischemia- reperfusion injury. Using an unbiased systems biology approach known as metabolic flux analysis, he has identified metabolic pathways that are unexpectedly regulated by EglN enzymes. The research proposed in his application will build on his preliminary data and explore the relevance of these metabolic effects of EglN1 in a preclinical model of cardiac arrest. The specific aims of the research proposed in this application are to (1) determine how EglN1 regulates glucose oxidation and cellular respiration (2) develop an in vivo model of metabolic flux analysis and determine how EglNs regulate cardiac metabolism and (3) determine if EglN inhibition is an effective treatment for cardiac arrest.